Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 036150460 | IL |
Y | 207V00000X | Obstetrician & Gynecologist | 12264845-1205 | UT |
N | 207VE0102X | Reproductive Endocrinologist | 12264845-1205 | UT |
NPI | 1346637709 |
---|---|
Provider Name | Ms. Ijeoma N. Iko |
First Address | Salt Lake City, UT 84132-2209 |
Second Address | Salt Lake City, UT 84132-2209 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2015 |
Last Update Date | 20/10/2021 |